Melissa Henry

Institut Lady Davis de recherches médicales de l'Hôpital général juif

Domaine : cancer

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2014-2015

Abstract

Background : While we know quality of life(QoL) to be severely impacted in head and neck cancer patients(H&N-CP), little is known about its psychological and social influences. Furthermore, the role of genes, well recognized as predisposing people to react intensely to stressful life events, has been understudied in oncology and in H&N-CP.

Study Purpose : This FRQS-funded proposal encompasses two studies. The purpose of Study 1 is to identify predictors of overall QoL (primary outcome) and psychological QoL in H&N-CP 3 months post-diagnosis. We also aim to explore QoL trajectories at 6 and 12 months post-diagnosis. The purpose of Study 2 is to explore the potential value of combining well-known genes and environmental stressors in predicting QoL and distress.

Methodology of Study 1 : Patients will complete self-report questionnaires <2weeks of their cancer diagnosis, as well as at 3-, 6-, and 12-month follow-up. We will examine the influence of: illness/treatment-related variables; past psychiatric and childhood history; body image and anxiety traits including social anxiety; concomitant life stressors; existential wellbeing; and degree of disfigurement. Methodology of Study 2 (using Study 1 participants): We will explore the influence on quality of life of a genetic risk factor involved in serotonin activity combined with environmental stressors (i.e.,early parental attachment, history of childhood abuse; stressful life events <past year).

Progress to date : Ethics approval has been obtained for Studies 1&2; recruitment seems feasible, with 97 patients recruited over 16 months and a retention rate of 76.2% at 3-month follow-up. Our preliminary analyses support the importance of the variables identified in this study.

Clinical Implications : Based on a rigorous approach combining this study's results, expert consultations, and a literature review on evidence-based practices, we will develop a targeted preventive psychological intervention with the goal of improving QoL, alleviating suffering, and reducing health care costs in H&N-CP.